Primary testicular lymphoma: experience with 13 cases and literature review
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ORIGINAL ARTICLE
Primary testicular lymphoma: experience with 13 cases and literature review Chu Wang • Hai Wang • Qinghai Wang Bingbing Shi
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Received: 19 October 2012 / Revised: 18 December 2012 / Accepted: 27 December 2012 / Published online: 25 January 2013 Ó The Japanese Society of Hematology 2013
Abstract To summarize the clinicopathological features, therapeutic regimens, and outcomes for patients with primary testicular lymphoma (PTL), we retrospectively reviewed the medical records of 13 patients diagnosed with PTL between 2001 and 2012 at our hospital. Average age at diagnosis was 62.2 ± 13.9 years, and all patients presented with painless testicular swelling. Diffuse large B-cell lymphoma was the dominant histotype (69.2 %). All 13 patients were treated with inguinal orchiectomy and received chemotherapy and/or radiotherapy. Complete follow-up data were available for 10 patients with an average follow-up duration of 28.4 ± 30.9 months. Seven patients were evaluated as Ann Arbor stage I or II, and three as stage III or IV. Eight patients were found to have hypoechogenic and hypervascular signals in the testis on ultrasound examination. Complete remission was achieved in six patients, and four patients who were still undergoing chemotherapy during the last follow-up showed no signs of relapse. Of the 10 patients with complete follow-up records, three had relapses, which occurred in the CNS, epiglottis, and the nasal cavity. Time to relapse in these cases was 2, 7, and 11 months, respectively (3/10). The mean progression-free survival was 22.57 months (range 1.1–101.9 months).
Keywords Primary testicular lymphoma Large B-cell lymphoma Testicular hydrocele Treatment Patient outcomes Abbreviations AFP Alpha-fetoprotein b-HCG b-Human chorionic gonadotropin CNS Central nervous system CT Computed tomography CR Complete remission DLBCL Diffuse large B-cell lymphoma DICE Dexamethasone, ifosfamide, cisplatin, and etoposide ESHAP Etoposide, solumedrol (methylprednisolone), ara-C (high-dose cytarabine), and cisplatin IPI International Prognostic Index MRI Magnetic resonance imaging NHL Non-Hodgkin’s lymphoma OS Overall survival PFS Progression-free survival PTL Primary testicular lymphoma
Introduction Electronic supplementary material The online version of this article (doi:10.1007/s12185-013-1261-8) contains supplementary material, which is available to authorized users. C. Wang H. Wang Q. Wang B. Shi (&) Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), 1 Shuaifuyuan, Wangfujing, Beijing 100730, China e-mail: [email protected]; [email protected]
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Primary testicular lymphoma (PTL) is a rare and highly aggressive extranodal non-Hodgkin’s lymphoma, with a median survival of 12–24 months [1]. PTL affects sites that are immune-privileged, such as the testicles and the central nervous system (CNS). In spite of the low overall incidence, it is the most common testicular malignancy in males between the age
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